Bisphosphonates and CRPS

[mid|ine]

Anyone have any experience with the use of bisphosphonates for treating CRPS? Apparently Neridronate is trying to come to market with CRPS as an indication. Also, some other studies show some efficacy.

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[joshmir]

the pain academic i respect the most felt it had the best evidence for crps efficacy

perhaps the response is better or worse in those who have changes on bone scan

i have used 40'day alendronate for 4-6 weeks in a few pts, haven't been burned, no miracle cures; i do this in old and new crps; i do this in paralell with other things, so non-scientific

i write in the sig for the script to stop immediately and go see their dentist if they develop any jaw pain (rare risk of osteonecrosis of the jaw)

 

[epidural man]

Anyone have any experience with the use of bisphosphonates for treating CRPS? Apparently Neridronate is trying to come to market with CRPS as an indication. Also, some other studies show some efficacy.

They clearly have the best pharmacoligical evidence for CRPS. I have tried it a few times. However, I am scared each time I do it. If I were to put someone in renal failure, or give them osteonecrosis of the jaw, I would not be very happy.

 

[lobelsteve]

They clearly have the best pharmacoligical evidence for CRPS. I have tried it a few times. However, I am scared each time I do it. If I were to put someone in renal failure, or give them osteonecrosis of the jaw, I would not be very happy.

Start treating the osteoporosis for all the compression fractures you see. It helps patients and is rewarding care. You will gravitate to Forteo>Prolia>reclast, and leave Fosamax and Boniva to the folks that are not near fracturing yet. I have seen 2-3 fractures per day this week. Weird. Vit C to prevent CRPS? Interesting. Bisphos to treat, good care. Still like steroids early on.

 

[DOctorJay]

The ED where I trained had a Vit C protocol for all distal extremity fractures that came in. Good evidence for it.

 

[clubdeac]

Steve! How are you getting that many VCFs!! I hate you...I'm gonna start running billboards advertising myself as the fracture fixer. They just aren't coming..

And don't forget, no ACE inhibitors. Break something while taking an ACE and your chances of developing CRPS increase substantially